Monday, April 25, 2005

Best Healthcare System in the World?

This case seems to encapsulate everything that's wrong with out healthcare system. The kid, Teron Francis, has a family thatclearly has lots of challenges and not a lot of resources, and Teron showed up for a root canal last week without the proper accompaniment or parental authorization. So, of course, the healthcare system did what it typically does when it encounters a bureaucratic hurdle--it threw up its hands and said, "sorry, we can't give you the treatment you need."

In the "greatest medical system in the world," a 13 year old died of a toothache because he didn't have the right paperwork. That's bat shit insane.

And, of course, there's a Schaivo-esque twist to all this: according to news reports, Teron is brain-dead, but his family is insisting he be kept on a respirator. There's some dispute between the hospital and the family--the family claims the hospital planned to take Teron off the respirator (which makes sense if he's brain dead), so the family filed an injunction to prevent it. The hospital, which apparently received Teron as a transfer patient when it was already too late to do anything for him, disputes the family's charge. And the icing on the cake is watching the Bronx's notoriously sleazy judiciary descend to a new low: this weekend, in a brilliant stunt, the wife of the judge who issued an injunction against removing the feeding tube ventilator prayed over the poor child's braindead body.

I can't imagine a better parable for our medical system: when it comes to preventive care, we're going to make it as difficult as possible for you to get the care you need in order to stay healthy. The roadblocks will be formidable, and if you fail to pass any of the system's tests--financial, bureaucratic, language or any other--it's going to be up to you, the sick person, to figure out the right way around them. But once you're dead, baby, you've hit the jackpot! The bureaucracies will magically align and they will move heaven and earth to preserve your quality of life.

2 Comments:

A 13-year-old Bronx boy whose family fought to keep him on a respirator for a week after he was declared brain dead succumbed to a bacterial infection, according to autopsy results unveiled yesterday.

Teron Francis' condition turned grave shortly after he was admitted to BronxLebanon Hospital Center in April for a headache.

Doctors initially believed a tooth infection may have spread to his brain.

The city medical examiner said yesterday Teron died of complications of meningoencephalitis - a swelling of the brain.

"There was a bacterial infection in his nasal cavity and the infection went to his brain," said Ellen Borakove, a spokeswoman for the agency.

Bronx-Lebanon spokesman Errol Schneer said hospital officials were "saddened by the untimely death of Teron Francis."

But the autopsy "indicates that the medical and dental care that he received at Bronx-Lebanon did not in any way contribute to his death," he said.

But a Francis family lawyer said there were still unanswered questions. "The real question is how is it that a 13-year-old child with a relatively routine condition of sinusitis ends up with bacterial meningitis that leads to his death," said Robert Genis, the Francis family's lawyer.

Teron was moved to Montefiore Medical Center on April 19 - the day after he was admitted to Bronx-Lebanon. He was declared brain dead shortly before noon on April 21.

State Supreme Court Judge Douglas McKeon made a dramatic bedside ruling the next night, heeding the family's pleas to keep him on the respirator. Teron's mom, Marcerlyn Francis, later agreed to let doctors take her son off the respirator after getting a